Improving Gender-Based Violence Screening through Collaborative Data Review with an HIV Service Delivery Partner

According to the World Health Organization, one out of every three women (35%) have experienced either physical and/or sexual intimate partner violence or non-partner sexual violence in their lifetime. The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) emphasizes the importance of GBV case identification and referral within prevention, testing, and treatment services. Data.FI collaborated with TMEC-RISE, a USAID-supported implementing partner, through weekly meetings to review and discuss HIV data, including data on GBV screening in Nigeria. The Data.FI team shared the results of high-frequency data that USAID-supported IPs report on key HIV cascade continuum indicators. A follow-up meeting with TMEC-RISE's gender focal person virtually identified potential barriers to poor GBV screening and elicited suggestions for improvement. Analysis showed that Adamawa and Cross River States had the lowest GBV screening rate among all states in Nigeria. A facility-level analysis conducted by Data.FI revealed that on average, only five percent of clients receiving HIV index testing services were screened for GBV across 10 health facilities with the lowest GBV screening rates. The identified factors contributing to low GBV screening included poor index testing counselling skills by healthcare workers, a restriction limiting HIV index testing and GBV screening services provision to health facilities, and poor capacity of data entry clerks in documenting and retrieving GBV screening reports. To address these barriers, stakeholders proposed and implemented strategies, including strengthening the capacity of facility and community health workers to incorporate GBV screening in index testing, counselling, and requesting clients to identify their sexual partners for index testing. Scaling up HIV index testing services to communities and ensuring that GBV screening is part of these services was also recommended. Building capacity of the facility technical staff on proper documentation and retrieval of data on GBV screening from different service delivery points was another proposed strategy. After implementing these strategies, Data.FI conducted another analysis of GBV screening, which showed that 56 percent of clients receiving index testing services were screened for GBV across the 10 health facilities. This reflected a 51 percentage-point increase compared to the baseline. To ensure continuous and sustained improvement of GBV screening services, TMEC-RISE trained and rolled out LIVES training across facilities, which includes listening to the victim during counselling, inquiring more about the type of violence perpetrated, validating by showing empathy, enhancing safety, and supporting referral to clinical and non-clinical services.